Does mesh/perimesh fibrosis have an effect on testicular arterial flow in patients with repaired inguinal hernia?

Purpose: Hernia repair includes implantation of a mesh. However, direct contact of the mesh to the vessels in the inguinal canal, and perimesh fibrosis may have a negative impact on testicular arterial flow. The aim of this study is to evaluate the effect of mesh implantation/perimesh fibrosis on testicular arterial impedance and perfusion after repair of indirect inguinal hernias.

Materials and methods: A total of 25 male patients (mean: 44.3 years) with unilateral IIH were included. Testicular arterial impedance and testicular perfusion in color/power Doppler US were assessed bilaterally. Testicular arterial RI and PI were examined at proximal, middle and distal inguinal canal, and extratesticular-intrascrotal locations. Measurements were made preoperatively(n:25) and 3 months postoperatively (n:20). Postoperative data of 8 patients were excluded due to haematoma(n:5), infection(n:2), and seroma(n:1). Measurements in the normal side were accepted as control group(n:25). Anova and Wilcoxon's test were used for statistical analysis.

Results: Mean values for RI were 0.86–0.85–0.82–0.77 in the preoperative, 0.87–0.85–0.82–0.74 in the postoperative, and 0.86–0.84–0.82–0.76 in the control groups, respectively. In all groups, RI and PI were highest in proximal inguinal and lowest in scrotal part (p<0.05). However, there was no difference in all measurements and testicular perfusion between the three groups.

Conclusion: Mesh implantation/perimesh fibrosis does not adversely affect the testicular arterial impedance and the testicular perfusion.